Parental control and a child’s diet

To understand the increase in childhood obesity, researchers have turned their attention to the child’s home environment and have highlighted the role of parental feeding practices. Central to this research has been the issue of parental control and the effectiveness of different approaches at controlling or managing a child’s diet, which is pertinent given the current availability of fast foods and unhealthy snacks. Some research has addressed the impact of control although studies have produced contradictory results. For example, Birch and colleagues have carried out a number of studies exploring the impact of control and have developed the Child Feeding Questionnaire which operationalizes control in terms of monitoring, restriction, and pressure to eat (CFQ)¹. Birch⁽²⁾ reviewed the evidence for the impact of imposing parental control and concluded from her review that “child feeding strategies that restrict children’s access to snack foods actually make the restricted foods more attractive”. In contrast, however, some studies suggest that parental control may actually reduce weight and improve eating behaviour. For example, Wardle and colleagues developed the Parental Feeding Style Questionnaire (PFSQ)³ which operationalizes control in terms of restriction with items such as “I control how many snacks my child should have”. Using this measure, Wardle et al⁽³⁾ suggested that “lack of control of food intake [rather than higher control] might contribute to the emergence of differences in weight”. Similarly, Brown and Ogden⁽⁴⁾ reported that greater parental control was associated with higher intakes of healthy snack foods. Ogden et al(⁵⁾ argued that these contradictory results may reflect the contradictory nature of parental control with some forms of control having beneficial effects while others may be detrimental. To explore this possibility, Ogden et al⁽⁵⁾ examined the effect of differentiating between ‘overt control’ which can be detected by the child (eg. being firm about how much your child should eat) and ‘covert control’ which cannot be detected by the child (eg. not buying unhealthy foods and bringing them into the house). This study developed a new measure of covert and overt control and showed that these different forms of control did differently predict snack food intake and, while higher covert control was related to decreased intake of unhealthy snacks, higher overt control predicted an increased intake of healthy snacks.

Overt versus covert control

A recent study by Brown, Ogden, Vogele and Gibson,⁽⁶⁾ aimed to further explore the role of parental control on both children’s BMI and their diets. Parental control practices were examined with a focus on overt and covert control and pressure to eat on a child’s eating patterns. In particular, the study explored the impact of these practices on a range of dietary behaviours including snack food consumption, the intake of fruit and vegetables, and neophobia, which can be a barrier to healthy eating as well as the child’s BMI. The study involved a cross sectional survey of 518 parents with children aged 4-7 years and was carried out in 18 primary schools across the South of England.

Differential effects of overt and covert control on children’s eating

The results from Brown et al⁽⁶⁾ showed that the most commonly used control practices were overt control (that can be detected by the child) over both meals and snacks and covert control (that cannot be detected) over meals, which were used by a large majority of the parents. In terms of the impact of these different parental control practices, the results showed no relationship between any of the control practices and the child’s BMI. However, associations between parental control practices and aspects of the child’s diet were found. In particular, eating more unhealthy snacks was related to less covert control and more pressure to eat, eating fruit and vegetables was related to higher levels of both overt and covert control over meals and less pressure to eat, and being neophobic was related to less covert control over meals and more pressure to eat. Ogden et al⁽⁵⁾ suggested that previous contradictory findings may reflect the complex nature of parental control with some controlling strategies promoting healthier behaviours than other strategies. The results from Brown et al (2007) support this analysis. In particular, ‘pressure to eat’ involves a very direct version of control such as trying to encourage a child to eat even when they say they are not hungry. Such an approach may be associated with less healthy behaviour and may even have a detrimental impact upon food choice. In contrast, covert control is a much more subtle and less direct approach to managing a child’s diet and involves avoiding unhealthy restaurants or not bringing unhealthy foods into the house. Such an approach may be associated with more healthy eating. Research exploring other forms of control indicate that trying not to do something or trying not to think about something can paradoxically make that behaviour or thought more likely to occur⁽⁷⁾. The results from Brown et al⁽⁶⁾ suggest that direct forms of control such as pressure to eat may result in this paradoxical effect, whereas more subtle forms of control such as covert control may not.

To conclude, the results showed that parental control practices are widespread and, whereas covert control was associated with a healthier diet, ‘pressure to eat’ was related to less healthy behaviour. Parents may believe that controlling their child’s diet is necessary given the current availability of fast food and unhealthy snacks. The results from this study indicated that some of these controlling practices may be more beneficial than others.